We are letting our nurses burn out
If mask-wearing is an indicator of pandemic alertness, Europe is in a state of fatigue. YouGov surveys indicate face coverings have dropped across the continent as vaccinations and booster shots pick up. In Paris, where new rules require masks even in the street, noses and mouths are regularly on display as a small act of rebellion.
Behind the fading fear of Covid is the sense that Omicron is not Delta, and that 2022 is not 2020. Indeed, there are signs the latest virus surge is plateauing in some countries, and deaths have decoupled from cases thanks to jabs and treatments. The old continent wants to move on. French Health Minister Olivier Veran even reckons this could be Covid’s “last wave”.
But we shouldn’t forget the literal pandemic fatigue facing healthcare workers. Hospitals are being put under strain as record infections push up overall admissions, even with fewer severe cases and less time requiring care. This has collided with a depleted workforce. Four out of five German hospitals have staffing problems, with 22,300 vacancies nationwide, according to a December survey. In France, estimates of total bed closures due to staff shortages vary between 5% and 20%.
Some of the crunch is due to infected workers, and governments are scrambling to cut isolation times after positive tests to bring people back to work sooner. But the staffing problems will outlast Omicron. Exhaustion, low pay and poor conditions have pushed nurses and doctors to change jobs. In-home care, lab testing and the private sector beckon. Violence from their own patients has disillusioned them. We used to clap for carers, now we let them burn out.
This is the wrong trajectory if we’re to live with Covid as a post-pandemic seasonal virus. Preparing for future variants and pandemics while caring for an ageing population will require more resources. Addressing health care shortages will be essential to avoid a repeat of Covid’s catastrophic financial cost and death toll or the hundreds of millions of dollars the UK spent on pandemic intensive-care facilities without enough trained staff.
History tells us that nursing shortages can last a long time if left unchecked. Public health will have to offer better pay and conditions — not simply a shorter qualification route to employment — especially in an inflationary environment where every sector of the economy is duking it out for talent. The UK offered a meagre 1% pay increase for health workers in March, then revised up to 3% a few months later; France has offered an extra 180 to 400 euros (7,980 to 15,000 baht) a month. These figures don’t look like a Marshall Plan for public health.
One example worth looking at is Italy.
The country’s 200-billion-euro spending plan for European Union recovery funds includes new community hospitals and “health houses”, a first point-of-contact for patients staffed by nurses and specialists. Professor Francesco Longo of Bocconi University tells me the emphasis is on local care to alleviate strain on hospitals and treat risk factors like hypertension and diabetes that make Covid deadlier.
To be sure, long-term spending won’t come easy for big European countries, which are already leading the world in health spending as a percentage of GDP and which now have higher debt loads along with limited room to tax.
This is where efficiency gains from technology might play a role, according to Afschin Gandjour of the Frankfurt School of Finance. Italy and France are ploughing money into digital health, ideally treating more patients at home and alleviating paperwork for staff. And hospitals could be one area where more robots would help humans do their jobs, rather than steal them. Johns Hopkins Medicine researchers have identified potential advantages of robotics in future outbreaks, such as improved monitoring of disease severity or eventually performing tasks like managing ventilators and monitors.
Hospitals will be but one key part of the next stage of Covid. The new normal will require more investment in everything from disease surveillance to vaccine research. But we shouldn’t forget the people we used to applaud.